CPT code 28456: Tarsal fracture fixation, percutaneous, with manipulation2026 Medicare rate & RVUs in Texas
Reports percutaneous skeletal fixation with manipulation of a tarsal bone fracture other than the talus or calcaneus, counted for each bone treated.
CMS doesn’t publish an office rate for 28456 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 28456 covers
This procedure treats a fracture of a tarsal bone other than the talus or calcaneus. The surgeon manipulates the fracture to improve alignment and stabilizes it with skeletal fixation placed percutaneously, without open exposure of the fracture. Orthopedic and foot-and-ankle surgeons typically perform it in an operating room when closed manipulation alone is not sufficient and fixation is needed.
Report the code for each qualifying tarsal bone treated. The operative report should identify the bone, document manipulation and percutaneous skeletal fixation, and support the number of bones billed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 28456 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $397.07 |
| Beaumont, TX | Unavailable | $357.69 |
| Brazoria, TX | Unavailable | $377.42 |
| Dallas, TX | Unavailable | $380.40 |
| Fort Worth, TX | Unavailable | $377.95 |
| Galveston, TX | Unavailable | $378.90 |
| Houston, TX | Unavailable | $389.70 |
| Rest of Texas | Unavailable | $367.73 |
How the 28456 rate is calculated
Each of 28456’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 28456
RVUs × geographic indexes × conversion factor
Work2.79
2.79 RVUs× 1.000 GPCI
Practice expense8.10
8.10 RVUs× 1.000 GPCI
Malpractice0.59
0.59 RVUs× 1.000 GPCI
Adjusted RVUs
11.4800
Conversion factor
$33.4009
Medicare rate
$383.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28456
28456 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28456
Tarsal fracture fixation, percutaneous, with manipulation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28456
Tarsal fracture fixation, percutaneous, with manipulation
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
28456 without 51 · national facility
$383.44
Tarsal fracture fixation, percutaneous, with manipulation
28456-51 · Second procedure: 50%
$191.72
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
28456 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 28455Tarsal fracture careEach tarsal bone
- Choose 28456 when manipulation is accompanied by percutaneous skeletal fixation. Code 28455 describes tarsal fracture treatment with manipulation without that fixation.
- 28465Tarsal fracture repairOpen treatment, each bone
- Code 28465 describes open treatment of a qualifying tarsal bone fracture. Code 28456 is for percutaneous skeletal fixation with manipulation.
- 28436Talus fracture fixationPercutaneous, with manipulation
- Code 28436 is the percutaneous fixation option for a talus fracture with manipulation. Code 28456 is for other tarsal bones, excluding the talus and calcaneus.
28456 billing questions
How does this differ from 28455?
Code 28456 includes percutaneous skeletal fixation as well as manipulation. Code 28455 is for manipulation without the percutaneous skeletal fixation described by 28456.
Which tarsal bones are included?
The code covers tarsal bones other than the talus and calcaneus. Those two bones have separate fracture-treatment codes.
How should units be counted?
The descriptor specifies each bone treated. Document the individual qualifying tarsal bone or bones that received manipulation and percutaneous fixation.
Can modifier 50 be used for bilateral treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service based on each qualifying bone treated.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this procedure, and co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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